CPC Anesthesia Coding Guidelines 5 — Questions and Answers
Question 1: A patient undergoing anesthesia for a procedure involving intracranial neurosurgery would be coded from which CPT range?
- 00100–00222
- 00300–00352
- 00600–00670 (Correct answer)
- 00700–00797
Correct answer: 00600–00670
CPT codes 00600–00670 cover anesthesia for procedures on the spine and spinal cord, while 00210–00222 cover intracranial procedures.
Question 2: Which of the following describes Monitored Anesthesia Care (MAC)?
- General anesthesia with endotracheal intubation
- Anesthesia care including potential conversion to general anesthesia with monitoring and sedation (Correct answer)
- Regional nerve block without sedation
- Epidural anesthesia for surgical procedures
Correct answer: Anesthesia care including potential conversion to general anesthesia with monitoring and sedation
MAC involves an anesthesia provider monitoring the patient with the ability to convert to general anesthesia, and may include sedation and analgesia.
Question 3: A CRNA providing anesthesia without any physician oversight uses which modifier?
- QX
- QZ (Correct answer)
- AA
- QK
Correct answer: QZ
Modifier QZ is used when a CRNA provides anesthesia services without medical direction by a physician.
Question 4: Which anesthesia code is reported for anesthesia during burn excision procedures covering more than 9% of the body surface?
- 01951
- 01952 (Correct answer)
- 01953
- 01999
Correct answer: 01952
CPT 01952 is reported for anesthesia for burn excisions or debridement involving more than 9% of the total body surface area.
Question 5: When reporting anesthesia for a surgeon who performs their own anesthesia, which modifier is used?
- 47 (Correct answer)
- AA
- QZ
- 23
Correct answer: 47
Modifier 47 is appended to the surgical procedure code when the surgeon administers regional or general anesthesia personally.
Question 6: The anesthesia formula (B + T + M) x CF represents which components, in order?
- Bilateral, Time, Modifier x Conversion Factor
- Base units, Time units, Modifying units x Conversion Factor (Correct answer)
- Base units, Total minutes, Medicare rate x Cost Factor
- Billing units, Time units, Miscellaneous x Carrier Fee
Correct answer: Base units, Time units, Modifying units x Conversion Factor
The anesthesia payment formula is: (Base units + Time units + Modifying units) multiplied by the Conversion Factor.
Question 7: Which statement is true regarding the use of CPT anesthesia codes versus the use of modifier 47?
- Modifier 47 is used when billing MAC services
- CPT anesthesia codes (00100–01999) are used by the anesthesia provider; modifier 47 is used by the surgeon (Correct answer)
- Modifier 47 replaces all anesthesia CPT codes for Medicare billing
- CPT anesthesia codes and modifier 47 can be reported together on the same claim
Correct answer: CPT anesthesia codes (00100–01999) are used by the anesthesia provider; modifier 47 is used by the surgeon
Anesthesia CPT codes 00100–01999 are reported by the anesthesiologist or CRNA, while modifier 47 is appended by the surgeon who personally administered anesthesia.
CPC Anesthesia Coding Guidelines 5
A patient undergoing anesthesia for a procedure involving intracranial neurosurgery would be coded from which CPT range?